Hemispherical and minimally invasive total hip reamers: a biomechanical analysis of use and design

BACKGROUND: The purpose of this study was to determine the accuracy of used and new reamer systems for both hemispherical and minimally invasive (MIS) acetabular reamers. METHODS: New and used hemispherical and MIS acetabular reamers were tested on a computer numerical control machine to ream holes in special machinable wax blocks. Each reamer was tested 3 times in sizes 48 mm through 55 mm. RESULTS: The used reamers significantly underreamed by an average of 1.33 vs 0.28 mm compared to new reamers. Hemispherical reamers underreamed significantly more than MIS reamers, with a mean difference of 0.99 vs 0.63 mm, respectively. Used hemispherical reamers showed an average ream undersize of 1.61 vs 0.37 mm, compared to new hemispherical reamers. Used MIS reamers showed an average ream undersize of 1.06 vs 0.20 mm for the new MIS reamers. CONCLUSIONS: For a manufacturer-specified reamer size, both hemispherical and MIS reamers underream. Newer reamers cut truer to expected values than used ones. MIS reamers performed more accurately than hemispherical reamers. Used acetabular reamer systems may negatively affect the sizing of prepared acetabular beds; therefore, awareness of this potential inaccuracy should be considered when performing total hip arthroplasty.